Transitions: Linkages From Jail To Community - Full Text View

Purpose

TRANSITIONS, a novel jail-release program for People Living with HIV/AIDS (PLWHA), will use evidence-based interventions and adapt them to create a comprehensive transitional program in Waterbury and New Haven County, Connecticut. Evidence-based interventions will include, but not be limited to, enhanced rapid HIV testing within the New Haven Community Correctional Center (NHCCC, local jail), intensive case management, continuity of buprenorphine treatment from the jail to the community setting and a novel Money Management (MM) program.

The HIV in Prisons Program and the Community Health Care Van (CHCV) at the Yale University AIDS Program, in collaboration with the Connecticut Department of Correction and the Waterbury Hospital Infectious Diseases Clinic, propose to expand the availability of opiate substitution treatment and to enhance clinical and social services for PLWHA, who are transitioning from the jail to the community setting.

As part of Transitions, we will develop a model Money Management program that we have used in community settings to improve health outcomes for socially and medically marginalized populations and adapt it for a jail-release program. The Transitions program will incorporate these elements into a combined intervention and will result in a clinical trial to compare the additional contribution of a money management program.

Condition	Intervention
HIV Substance Abuse HIV Infections	Behavioral: Intensive Case Management Drug: Buprenorphine Behavioral: Money Management


Study Type:	Interventional
Study Design:	Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Supportive Care
Official Title:	Transitions: Linkages From Jail to Community

Resource links provided by NLM:

MedlinePlus related topics: HIV/AIDS

Drug Information available for: Buprenorphine Buprenorphine hydrochloride

U.S. FDA Resources

Further study details as provided by Yale University:

Primary Outcome Measures:

Substance use outcomes measured by self-report [ Time Frame: weekly reporting ] [ Designated as safety issue: No ]
Urine toxicology results [ Time Frame: weekly report ] [ Designated as safety issue: No ]


Enrollment:	127
Study Start Date:	September 2008
Study Completion Date:	August 2013
Primary Completion Date:	August 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Behavioral counseling	Behavioral: Intensive Case Management Transitions involves the integration of evidence-based interventions, intensive case management that incorporates outreach elements similar to assertive community treatment (ACT). Intensive case management goes beyond the tenets of case management and incorporates community outreach. This model of case management has its roots in assertive community treatment (ACT) and has demonstrated a 37% greater reduction in homelessness and a 26% greater improvement in psychiatric symptom severity compared with standard case management treatments. As such, intensive case management is likely to result in important outcomes for the target population, is evidence-based and has been validated in prison-release programs. Drug: Buprenorphine All participants that have a history of opiate dependency and need treatment with opiate substitution therapy will be offered Buprenorphine as an option for their substance use. For those who need additional or more structured treatment will be referred to methadone maintenance program. Behavioral: Money Management All participants will be offered money management as a component for further assistance to this population who need financial management services in order to stabilize them and help with the transition back into the community upon release from incarceration.

Arms

Assigned Interventions

Behavioral counseling

Behavioral: Intensive Case Management

Transitions involves the integration of evidence-based interventions, intensive case management that incorporates outreach elements similar to assertive community treatment (ACT). Intensive case management goes beyond the tenets of case management and incorporates community outreach. This model of case management has its roots in assertive community treatment (ACT) and has demonstrated a 37% greater reduction in homelessness and a 26% greater improvement in psychiatric symptom severity compared with standard case management treatments. As such, intensive case management is likely to result in important outcomes for the target population, is evidence-based and has been validated in prison-release programs.

Drug: Buprenorphine

All participants that have a history of opiate dependency and need treatment with opiate substitution therapy will be offered Buprenorphine as an option for their substance use. For those who need additional or more structured treatment will be referred to methadone maintenance program.

Behavioral: Money Management

All participants will be offered money management as a component for further assistance to this population who need financial management services in order to stabilize them and help with the transition back into the community upon release from incarceration.

Show Detailed Description

Eligibility


Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

HIV Seropositive
18 years of age or older
male and female
incarcerated but not sentenced inmates
releasing to New Haven area
releasing to Waterbury area
within 30 days post release from jail

Exclusion Criteria:

Not meeting inclusion criteria

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00841711

Locations


United States, Connecticut
Yale Clinical Research
New Haven, Connecticut, United States, 06510
Waterbury Hosp ID Clinic
Waterbury, Connecticut, United States, 06708

Sponsors and Collaborators

Yale University

Investigators


Principal Investigator:	Frederick L Altice, MD	Yale University

More Information

Publications:

Chen NE, Meyer JP, Avery AK, Draine J, Flanigan TP, Lincoln T, Spaulding AC, Springer SA, Altice FL. Adherence to HIV treatment and care among previously homeless jail detainees. AIDS Behav. 2013 Oct;17(8):2654-66. doi: 10.1007/s10461-011-0080-2.

Althoff AL, Zelenev A, Meyer JP, Fu J, Brown SE, Vagenas P, Avery AK, Cruzado-Quiñones J, Spaulding AC, Altice FL. Correlates of retention in HIV care after release from jail: results from a multi-site study. AIDS Behav. 2013 Oct;17 Suppl 2:S156-70. doi: 10.1007/s10461-012-0372-1.

Chitsaz E, Meyer JP, Krishnan A, Springer SA, Marcus R, Zaller N, Jordan AO, Lincoln T, Flanigan TP, Porterfield J, Altice FL. Contribution of substance use disorders on HIV treatment outcomes and antiretroviral medication adherence among HIV-infected persons entering jail. AIDS Behav. 2013 Oct;17 Suppl 2:S118-27. doi: 10.1007/s10461-013-0506-0.

Williams CT, Kim S, Meyer J, Spaulding A, Teixeira P, Avery A, Moore K, Altice F, Murphy-Swallow D, Simon D, Wickersham J, Ouellet LJ. Gender differences in baseline health, needs at release, and predictors of care engagement among HIV-positive clients leaving jail. AIDS Behav. 2013 Oct;17 Suppl 2:S195-202. doi: 10.1007/s10461-012-0391-y.

Fu JJ, Herme M, Wickersham JA, Zelenev A, Althoff A, Zaller ND, Bazazi AR, Avery AK, Porterfield J, Jordan AO, Simon-Levine D, Lyman M, Altice FL. Understanding the revolving door: individual and structural-level predictors of recidivism among individuals with HIV leaving jail. AIDS Behav. 2013 Oct;17 Suppl 2:S145-55. doi: 10.1007/s10461-013-0590-1.

Zelenev A, Marcus R, Kopelev A, Cruzado-Quinones J, Spaulding A, Desabrais M, Lincoln T, Altice FL. Patterns of homelessness and implications for HIV health after release from jail. AIDS Behav. 2013 Oct;17 Suppl 2:S181-94. doi: 10.1007/s10461-013-0472-6.

Krishnan A, Wickersham JA, Chitsaz E, Springer SA, Jordan AO, Zaller N, Altice FL. Post-release substance abuse outcomes among HIV-infected jail detainees: results from a multisite study. AIDS Behav. 2013 Oct;17 Suppl 2:S171-80. doi: 10.1007/s10461-012-0362-3.


Responsible Party:	Yale University
ClinicalTrials.gov Identifier:	NCT00841711 History of Changes
Other Study ID Numbers:	0711003262, H97HA08541
Study First Received:	February 10, 2009
Last Updated:	August 26, 2014
Health Authority:	United States: Institutional Review Board

Keywords provided by Yale University:


HIV AIDS Buprenorphine Intensive Case Management Money Management	Rapid Testing Substance Abuse Opioid Dependance Inmate Population

Additional relevant MeSH terms:


Buprenorphine Analgesics Analgesics, Opioid Central Nervous System Agents Central Nervous System Depressants Narcotic Antagonists	Narcotics Peripheral Nervous System Agents Pharmacologic Actions Physiological Effects of Drugs Sensory System Agents Therapeutic Uses

ClinicalTrials.gov processed this record on March 03, 2015